Provider Demographics
NPI:1891911434
Name:ESPER, SUSAN EROSSY (PT)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:EROSSY
Last Name:ESPER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10043 DOMINION VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-7905
Mailing Address - Country:US
Mailing Address - Phone:704-766-1553
Mailing Address - Fax:704-766-1554
Practice Address - Street 1:10043 DOMINION VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-7905
Practice Address - Country:US
Practice Address - Phone:704-766-1553
Practice Address - Fax:704-766-1554
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10569225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist